What Will It Take To Save Our People???

Hello Everyone, My name is Sharon Ferrer and I am a 3 1/2 years post op patient posting from Orlando, Florida. I used to weigh 600 lbs. and through Roux NY Weight Loss Surgery I have lost 420 pounds. Now I weigh 195 lbs. and I am a healthy, happy and productive human being able to enjoy life to the fullest with my family and friends. Well, this is not the story of Rafael Charron which died in Orlando, Florida last night at age 52, of morbid obesity related complications. He left his family and friends in a devastated emotional state and with no answers as to why Medicaid failed to keep him alive. Rafael weighed 749 lbs. and although this number should be sufficient criteria to certify medical necessity for the surgery to be approved it was not. The case was submitted to Medicaid for approval and the approval was denied. Although the details of his denial are not clear to me at this point and they are been investigated, the point is that another life has been lost to the burocracy of medical plan companies and their senseless denials. His heart gave up! He was treated on a "guesstimate" basis since there was no accurate and adecuate equipment at Orlando Regional Hospital nor Sand Lake Hospital to treat his condition. I've cried bitterly since I was going to help him today to resubmit his surgery case via a consult through Dr. William Todd Overcash and have his staff work with him on meeting the medical criteria Medicaid requires to approve the surgery to bring him to health. He did not have adecuate care at the hospital. His dignity was violated! Unfortunately, I was not able to help him with this. He died before I could help him resubmit and find better medical care conditions for him. Please post your opinions about this subject! Let our fellow people know how to bypass this burocracy. At this point, we need to take responsibility and email, write letters to our representatives, congressmen, senators and all of these medical plan companies that are only thinking about how to save their money instead of saving lives. There was no reason for Rafael and many others like him to die! So many of our morbidly obese people are dead because of this type of burocracy. Are we going to fly to another country and get this surgery done out of pocket, at a cheaper rate, just like the prescription drugs some of us buy from Canada and Mexico because they are not covered by the medical plans? People like him are not able to do this. They can't even get out of bed to go to the bathroom!!! We are paying for these medical benefits. We are tax payers! This was not a pro bono service... How could the system fail him??? By the same token, all of these private medical plan providers fail to approve the patients on the first attempt to discourage the patient from trying to go the surgery. We all have to appeal, try 2, 3 times and educate ourselves as to what are the criterias for approval so we can taclkle them. These benefits, which we are entitled to don't come to us for free. We pay for them through our jobs. Let's all unify and start making a difference. It is my mission for to become an advocate to this cause. NO ONE should die of morbid obesity. Therfore, I will be posting info on message boards as I come across it on how we can communicate with lawyers, senators congressmen and anyone who would be able to help us change the laws and prevent these tragedies from happening, ways on how to handle appeals, who to contact for low cost legal representation after a third denial etc. Education is the key word here in order to fight this monster. We need to set presedent and raise awareness on talk shows, newspapers, cable news shows and in every forum we can find to change the laws and create new ones to benefit our fellow morbidly obese people. As of right now there are no laws or acts, protecting the rights of morbidly obese people. Horror stories are always portrayed on TV about the complications involving surgery or how to enhance our appearance after loosing the weight via plastic surgery. However, stories about us loosing people to this disease due to all this burocracy are not portrayed or published. Let's all brake the cycle! This is condition is more emotionally and physically painful than been a handicapped person. The difference is that handicapped people don't die for having a handicap. They can live happy and productive lives. Unfortunately, we do die of morbid obesity. Please don't let Rafael Charron's death go unnoticed. Let's all try our hardest to help our fellow morbid obese people avoid death due to this disease and the monster of medical plan denials and burocracy. Shame on Medicaid... Shame on all the private medical providers allowing this to happen. Let's all pray for our dead and for the ones that may be at the brink of leaving us as well but are still fighting a no win battle if we don't help them. The clock is ticking!!! Hugs to all, Sharon

Sharon, I'm so sorry to hear about your friend Rafael passing. I agree with you that we ALL must fight for ALL insurance companies to cover WLS. So many people die on a daily bases that we are not even aware of due to obesity. Donna 338/190 -148

I completely agree. I have been fighting for months for this surgery. I was denied the first time and just recently got an approval after sending in the appeal. I was totally shocked that they actually approved it and will not breathe freely until I come out of the recovery room. I still expect them to stop it somehow, although technically I know they cannot stop it since they gave me an approval. I will be having my surgery on August 25th and I am one of the lucky ones. However, my health deteriorated a good bit in the 6 months I was doing their little delaying "6 months doctor supervised diet." I have suffered a lot and have been terrified for months that I was going to die before having the surgery. It should not have been that hard of a fight. If I had needed chemotherapy, my insurance would not have questioned it. If I had needed open heart surgery, my insurance would not have questioned it. But since I suffered from morbid obesity, they humiliated me and made me go through hell. I intend to fight for this cause with every breath I have. When I think of all that I went through, all that others are going through and all that the families of people like Rafael are going through, I get so mad because he could have been a wonderful success story if the medical providers had a CLUE about this disease. You are right. We are the ones who have to educate people. I'm so sorry for the loss of your friend.....OUR friend. He was one of us. Thank you for your post. Joni